BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
NPI 1174064455
Clinic/Center - Federally Qualified Health Center (FQHC) in Holiday Island, AR

NPI Status: Active since March 20, 2017

Contact Information

1 PARK DR
SUITE C
HOLIDAY ISLAND, AR
ZIP 72631
Phone: (870) 448-5101

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  • Organization
  • Clinic/Center
  • Federally Qualified Health Center (FQHC)
  • CLIA Number: 04D0887822
  • CLIA Cert. Type: Federally Qualified Health Center
  • CLIA Exp. Date: 01-15-2028

About BOSTON MOUNTAIN RURAL HEALTH CENTER, INC

This page provides the complete NPI Profile along with additional information for Boston Mountain Rural Health Center, Inc, a primary care provider established in Holiday Island, Arkansas operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1174064455 assigned on March 2017. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Debbie Ackerson (Ceo)

NPI
1174064455
Provider Name
BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
Entity Type
Organization
Location Address
1 PARK DR SUITE C HOLIDAY ISLAND, AR 72631
Location Phone
(870) 448-5101
Mailing Address
PO BOX 1060 MARSHALL, AR 72650
Mailing Phone
(870) 448-5101
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-20-2017
Last Update Date
01-28-2019
Code Navigator

A primary care provider (PCP) like Boston Mountain Rural Health Center, Inc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Federally Qualified Health Center (FQHC)

Taxonomy Code
261QF0400X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DEBBIE ACKERSON

Authorized Official Title
CEO
Authorized Official Phone
(870) 448-5733

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
04D0887822
Facility Type
Federally Qualified Health Center
Certificate Effective Date
January 16, 2026
Certificate Expiration Date
January 15, 2028
Laboratory Director
LARRY J. JENNINGS
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Boston Mountain Rural Health Center, Inc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1174064455, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
4
Doubled → 8
Pos 8
4
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 0 → 0 4 → 8 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 4 + 4 + 0 + 6 + 8 + 4 + 1 + 0 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1174064455.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Dentist
1 PARK DR, STE D
HOLIDAY ISLAND, AR 72631
Psychiatry & Neurology (Psychiatry)
1 PARK DR, SUITE C
HOLIDAY ISLAND, AR 72631
Registered Nurse
1 PARK DR, SUITE A
HOLIDAY ISLAND, AR 72631
Family Medicine
1 PARK DR, SUITE C
HOLIDAY ISLAND, AR 72631
Speech-Language Pathologist
1 PARK DR, SUITE A
HOLIDAY ISLAND, AR 72631
Occupational Therapy Assistant
1 PARK DR, SUITE A
HOLIDAY ISLAND, AR 72631
Occupational Therapy Assistant
1 PARK DR
EUREKA SPRINGS, AR 72631

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174064455, enumerated as an "organization" on March 20, 2017.

The provider is located at 1 PARK DR SUITE C HOLIDAY ISLAND, AR 72631 and the phone number is (870) 448-5101.

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).